Provider Demographics
NPI:1023197688
Name:HARKRADER, CAROL E (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:E
Last Name:HARKRADER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:HARKRADER
Other - Last Name:PINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2279
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20134-2279
Mailing Address - Country:US
Mailing Address - Phone:540-338-7211
Mailing Address - Fax:866-740-1396
Practice Address - Street 1:170 WEST MAIN ST
Practice Address - Street 2:204
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132
Practice Address - Country:US
Practice Address - Phone:540-338-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010421072084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E49089Medicare UPIN